General Motors Cancer Research Prizewinners Laureates Lectures. Charles F. Kettering Prize. Clinical trials in testicular cancer.

Abstract

Testicular cancer has become a model for a curable neoplasm. Our studies with cisplatin combination chemotherapy allow us to conclude that (1) short-duration intensive induction therapy with the most active agents in optimal dosage is more important than maintenance therapy; (2) modest dose escalation increases toxicity without improving therapeutic efficacy; (3) it is possible to develop curative salvage therapy for refractory germ cell tumors; and (4) preclinical models predicting synergism, such as vinblastine+bleomycin or cisplatin+VP-16, have clinical relevance. Finally, testicular cancer also has become a model for new drug development. Cisplatin was approved by the FDA for testis and ovarian cancer and VP-16 and ifosfamide for refractory germ cell tumors. The success of these studies confirms the importance of the continued search for new investigational drugs in all solid tumors.